Takeaways given performance, considerations of data limitations
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Achievements
Here, we will review:
Airway-18 (Waveform Capnography Use for Airway Confirmation)
Asthma-01 (Beta Agonist Administration for Asthma)
Hypoglycemia-01 (Treatment of Symptomatic Hypoglycemia)
Safety-01 (Non-Use of Lights and Sirens During Response)
Achievements
Here, we will review:
Safety-02 (Non-Use of Lights and Sirens During Transport)
Trauma-01 (Pain Assessment in Trauma Patients)
Trauma-03 (Pain Reduction Achieved)
Airway-18
This process measure tracks the use of waveform capnography for confirming and monitoring advanced airway placement.
Asthma-01
Hypoglycemia-01
Safety-01
Safety-02
Trauma-01
Trauma-03
Gaps
Here, we will review:
Airway-01 (First-Attempt Advanced Airway Success)
Airway-05 (Preoxygenation Prior to Intubation)
Pediatrics-03b (Documentation of Weight for Weight-Based Medications)
Respiratory-01 (Assessment of Respiratory Distress)
Respiratory-02 (Oxygen Administration for Hypoxia)
Gaps
…in addition:
Safety-04 (Pediatric Restraint Use During Transport)
Seizure-02 (Benzodiazepine Administration for Status Epilepticus)
Stroke-01 (Stroke Assessment in Suspected Stroke Patients)
Syncope-01 (ECG Performed for Syncope)
Gaps
…along with:
Trauma-04 (Transport to a Trauma Center)
Trauma-08 (Trauma Vital Signs Documentation)
Trauma-14 (Pre-Arrival Trauma Alerts)
TTR-01 (Vital Signs for Non-Transported Patients)
TBI-01 (Documentation of Key Physiological Parameters)
Airway-01
This outcome measure assesses the percentage of EMS responses initiated through a 911 call in which advanced airway placement was successful on the first attempt without documented episodes of hypotension or hypoxia during the peri-intubation period.
Airway-05
Pediatrics-03b
Respiratory-01
Respiratory-02
Takeaways
Demonstrates national leadership in operational safety practices
Significant reduction in lights and sirens use during both response and transport
Leads peer states in waveform capnography adoption
Takeaways
Excels in clinical care performance
Strong results in asthma treatment and hypoglycemia management
Slightly exceeds national averages in trauma pain assessment
Evidence of a strong commitment to quality improvement across agencies
Takeaways
Key gaps in clinical performance:
Airway management, trauma triage, stroke care, seizure treatment, syncope evaluation
Persistent pediatric care and documentation deficiencies
Takeaways
Data completeness and accuracy remain limiting factors for system improvement
Many EMS professionals record critical details only in narratives, not in discrete data fields
Transitioning from narrative-heavy to structured documentation is essential for valid performance measurement
Strategic Priorities
Iowa’s proven record of progress positions it well for future EMS quality gains
Expand clinical education and simulation-based training
Reinforce standardized EMS protocols statewide
Address pediatric care disparities directly
Strategic Priorities
Iowa’s proven record of progress positions it well for future EMS quality gains
Improve EMS data quality: transition from narrative-heavy documentation to structured, discrete data fields for accurate performance measurement
Modernize and strengthen EMS data infrastructure
Analyses
At BEMTS, we have been hard at work creating open source software that benefits Iowans and other jurisdictions.
{nemsqar} package page
Questions?
Thanks!
Nicolas Foss, Ed.D., MS
Epidemiologist
Bureau of Emergency Medical and Trauma Services
Bureau of Health Statistics
Division of Public Health > Iowa HHS
C: 515.985.9627 || E: nicolas.foss at hhs.iowa.gov
